Patient/caregiver was educated on how to take Digoxin as follows:

• 1. Take this medication as ordered by your physician. Do not change the dose and frequency on this medication without consulting your doctor.
  2. Take the medication dose at the same time, every day, to avoid forgetting the intake of medication.
  3. Taking the medication at regularly spaced intervals helps with maintaining appropriate blood levels of digoxin needed to derive the beneficial effects for optimal cardiac function.
  4. Take the digoxin regular tablet as a whole, using a glass of water. Individuals can experience severe nausea and vomiting, when the medication is taken on empty stomach. Taking dose of digoxin with a glass of water, after having some food or a snack can help avoid having unpleasant gastrointestinal symptoms with the medication.
  5. If you encounter difficulty swallowing the whole tablet, you may cut the tablet and swallow it in pieces with a glass of water. You can also crush the regular tablet and sprinkle the powder on a spoon of apple sauce or jello or pudding, to facilitate an easy swallow.
  6. If you are prescribed digoxin capsule, try to swallow the capsule as a whole, with a glass of water. If you encounter difficulty swallowing the whole capsule, you may open the capsule and sprinkle the contents on a spoonful of apple sauce or jello or pudding, to facilitate an easy swallow.
  7. For individuals with swallowing difficulties, digoxin could also be administered orally, as an elixir. Use the calibrated dropper provided along with the digoxin elixir, to measure the appropriate dose of the elixir and avoid risk for over/under dosing. Using regular teaspoons and tablespoons for measuring dose of digoxin could involve serious risk of overdose and digoxin toxicity, which can be life-threatening. Also, do not forgot to shake the elixir well before you use it.
  8. For individuals with swallowing difficulties and unpleasant nausea and vomiting sensations with oral medication intake, digoxin is also available as a shot, to be administered via the intravenous route. Your physician could consider this option, if needed.
  9. Digoxin interacts with a lot of other medications, such as, diuretics, OTC mineral supplements, and antibacterial/antifungal antibiotics, thus resulting in complications. If you are being newly started on digoxin, discuss with your physician regarding all your current medications and their safety with digoxin. Also, notify your physician regarding any current digoxin intake, if you are being started on any new medications and discuss their safety with digoxin.
  10. Significant portion of digoxin dose is excreted unchanged in urine. Patients with history of compromised renal function could accumulate more medication in their blood stream, as their renal function is deficient and the kidneys are unable to clear the medication in the urine. This can result in a serious risk of digoxin toxicity, which can be life-threatening. So, periodical labs could be ordered to evaluate the renal function and prevent risk for digoxin toxicity.
  11. Your physician could change the dose of digoxin, based on the relief obtained, side-effects developed, lab results, and cardiac function studies obtained. Maintain compliance with follow-up physician appointments and observe compliance with any lab draws and cardiac function studies ordered. Be accommodative to the plan of dose changes, if need be, until you show an optimum response.
  12. Sudden discontinuation of digoxin intake, after prolonged use, can result in worsening of the heart failure and fatal arrhythmias, with consequent increase in fluid retention, pedal edema, shortness of breath, episodes of dizziness, and confusion. Discontinuation on digoxin intake must be only under your physician’s guidance and recommendation.
  13. If you miss a dose, try taking it at the earliest notice of noncompliance. If it is time for the next dose, skip the missed dose and take the dose scheduled. Do not take an extra dose to try making up for the missed dose. Notify your doctor and other health care personnel regarding your dose noncompliance.